PDO线联合自体颗粒脂肪填充在下睑年轻化中的应用探讨(1)
[摘要]目的：观察PDO(p-dioxanone)线联合自体颗粒脂肪填充治疗下睑老化的临床效果。方法：收集2015年3月-2018年12月，78例于笔者医院行PDO线联合自体颗粒脂肪填充治疗下睑老化的就医者，按Hirmand标准分型，采用双盲法，对就医者治疗前后按Sadick泪槽等级量表(TTRS)、Barton坡度分类法进行评分比较，并观察其治疗效果。结果：术后随访3～36个月，失访6例，其余就医者下睑老化均得到改善，对术后效果表示满意;就医者治疗后各项评分均低于治疗前，差异具有统计学意义(P<0.05)。结论：PDO线联合自体颗粒脂肪填充治疗下睑部老化的临床疗效明显，尤其是对于轻中度膨隆型下睑袋(无明显皮肤松弛)伴不同程度泪槽畸形所致的下睑部老化就医者，就医者术后恢复快、并发症少、满意率高，值得推广应用。
[关键词]PDO线;埋线提升;自体颗粒脂肪;注射填充;下睑袋;泪槽
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2019)05-0025-04
Curative Effect Observation of PDO Combined with Autologous Granular Fat Filling in Lower Eyelid Rejuvenation
LU Shang-bing，LI Jun-cen，SHUI Wen-xiang，WANG Na，WEI Jia-bin，GAO Liang，KANG Chun-yu
(Department of Plastic and Aesthetic Surgery，Milanbavii Medical Aesthetic Hospital，Chengdu 610000，Sichuan，China)
Abstract： Objective To observe clinical curative effect of PDO(p-dioxanone)combined with autologous granular fat filling in Lower eyelid rejuvenation. Methods From March 2015 to December 2018， 78 patients with lower eyelid aging were treated with PDO combined with autologous granular fat filling. Classification according to Hirmand criteria， used double-blind method， the patients were scored according to Sadick Tear Groove Rating Scale (TTRS) and Barton Grade Classification before and after treatment， and the therapeutic effect was observed. Results All patients were followed up for 3 to 36 months， lost 6 patients. The lower eyelid rejuvenation of the rest of the patients improved， and to express satisfaction with the results of the operation. The scores after treatment were lower than those before treatment， and the differences were statistically significant(P<0.05). Conclusion The effect of PDO line combined with autologous fat filling in the treatment of lower eyelid aging is obvious， especially in the light and moderate bulging lower eyelid aging(without obvious skin relaxation) with different degrees of deformity of lacrimal slots， and the patients recover quickly， the complications are less， and the rate of satisfaction is high. It is worth popularizing.
Key words： PDO line; buried thread lifting; autologous granular fat; injection filling; lower eyelid aging; lacrimal groove
随着年龄的增长，由于下睑皮肤、眼轮匝肌、眶隔退变松弛、眶脂肪移位及脫垂等病理改变导致下睑组织发生臃肿、膨隆或下垂，形成睑袋，造成下睑老化[1-3]。下睑袋形成是下睑老化的主要表现，通常还可伴有泪槽畸形、睑颊沟畸形[4]。临床治疗通常采用睑袋修复术，去除松弛的多余皮肤及眶脂，加强和修复各层组织，但下睑袋形成的原因具有多样性，一般可分为以下几种类型：单纯眼轮匝肌肥厚型、单纯皮肤松弛型、眶隔脂肪脱垂型和眶脂脱垂伴皮肤松弛型[5]。针对不同类型和程度，临床治疗方法也不一样。笔者选取78例下睑老化就医者，采用PDO线联合自体颗粒脂肪填充治疗，取得了良好的治疗效果，尤其对眶隔脂肪膨出、无明显皮肤松弛的下睑袋伴有HirmandⅠ型和Ⅱ型的泪槽畸形的就医者疗效显著，现报道如下。, 百拇医药(卢尚兵 李俊岑 税文祥)
[关键词]PDO线;埋线提升;自体颗粒脂肪;注射填充;下睑袋;泪槽
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2019)05-0025-04
Curative Effect Observation of PDO Combined with Autologous Granular Fat Filling in Lower Eyelid Rejuvenation
LU Shang-bing，LI Jun-cen，SHUI Wen-xiang，WANG Na，WEI Jia-bin，GAO Liang，KANG Chun-yu
(Department of Plastic and Aesthetic Surgery，Milanbavii Medical Aesthetic Hospital，Chengdu 610000，Sichuan，China)
Abstract： Objective To observe clinical curative effect of PDO(p-dioxanone)combined with autologous granular fat filling in Lower eyelid rejuvenation. Methods From March 2015 to December 2018， 78 patients with lower eyelid aging were treated with PDO combined with autologous granular fat filling. Classification according to Hirmand criteria， used double-blind method， the patients were scored according to Sadick Tear Groove Rating Scale (TTRS) and Barton Grade Classification before and after treatment， and the therapeutic effect was observed. Results All patients were followed up for 3 to 36 months， lost 6 patients. The lower eyelid rejuvenation of the rest of the patients improved， and to express satisfaction with the results of the operation. The scores after treatment were lower than those before treatment， and the differences were statistically significant(P<0.05). Conclusion The effect of PDO line combined with autologous fat filling in the treatment of lower eyelid aging is obvious， especially in the light and moderate bulging lower eyelid aging(without obvious skin relaxation) with different degrees of deformity of lacrimal slots， and the patients recover quickly， the complications are less， and the rate of satisfaction is high. It is worth popularizing.
Key words： PDO line; buried thread lifting; autologous granular fat; injection filling; lower eyelid aging; lacrimal groove
随着年龄的增长，由于下睑皮肤、眼轮匝肌、眶隔退变松弛、眶脂肪移位及脫垂等病理改变导致下睑组织发生臃肿、膨隆或下垂，形成睑袋，造成下睑老化[1-3]。下睑袋形成是下睑老化的主要表现，通常还可伴有泪槽畸形、睑颊沟畸形[4]。临床治疗通常采用睑袋修复术，去除松弛的多余皮肤及眶脂，加强和修复各层组织，但下睑袋形成的原因具有多样性，一般可分为以下几种类型：单纯眼轮匝肌肥厚型、单纯皮肤松弛型、眶隔脂肪脱垂型和眶脂脱垂伴皮肤松弛型[5]。针对不同类型和程度，临床治疗方法也不一样。笔者选取78例下睑老化就医者，采用PDO线联合自体颗粒脂肪填充治疗，取得了良好的治疗效果，尤其对眶隔脂肪膨出、无明显皮肤松弛的下睑袋伴有HirmandⅠ型和Ⅱ型的泪槽畸形的就医者疗效显著，现报道如下。, 百拇医药(卢尚兵 李俊岑 税文祥)